MEDICARE: SLEEP MEDICINE PC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	174400000X	Specialist	25210	AL

General Provider Information

NPI Number	:	1770542573
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SLEEP MEDICINE PC

Provider Business Mailing Address
First Line	:	802 MULLINS HILL DR SE
Second Line	:
City	:	HUNTSVILLE
State	:	AL
Zip	:	35802-1964
Country	:	US
Telephone Number	:	256-882-3458
Fax Number	:	931-685-9707

Provider Business Practice Location Address
First Line	:	380 WOODS COVE RD
Second Line	:
City	:	SCOTTSBORO
State	:	AL
Zip	:	35768-2428
Country	:	US
Telephone Number	:	256-218-3639
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	DANIEL G MCDONOUGH
Credential	:	MD
Telephone Number	:	256-882-3458

Provider Enumeration Date	:	03/21/2006
Last Update Date	:	08/22/2020

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Directions to “SLEEP MEDICINE PC ” Practice Location

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